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Ultrasonically activated scalpel versus monopolar electrocautery shovel in laparoscopic total mesorectal excision for rectal cancer

机译:超声手术刀与单极电灼铲在腹腔镜全直肠系膜切除术中治疗直肠癌的关系

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摘要

AIM: To investigate the feasibility and safety of monopolar electrocautery shovel (ES) in laparoscopic total mesorectal excision (TME) with anal sphincter preservation for rectal cancer in order to reduce the cost of the laparoscopic operation, and to compare ES with the ultrasonically activated scalpel (US).METHODS: Forty patients with rectal cancer, who underwent laparoscopic TME with anal sphincter preservation from June 2005 to June 2007, were randomly divided into ultrasonic scalpel group and monopolar ES group, prospectively. White blood cells (WBC) were measured before and after operation, operative time, blood loss, pelvic volume of drainage, time of anal exhaust, visual analogue scales (VAS) and surgery-related complications were recorded.RESULTS: All the operations were successful; no one was converted to open procedure. No significant differences were observed in terms of preoperative and postoperative d 1 and d 3 WBC counts (P = 0.493, P = 0.375, P = 0.559), operation time (P = 0.235), blood loss (P = 0.296), anal exhaust time (P = 0.431), pelvic drainage volume and VAS in postoperative d 1 (P = 0.431, P = 0.426) and d 3 (P = 0.844, P = 0.617) between ES group and US group. The occurrence of surgery-related complications such as anastomotic leakage and wound infection was the same in the two groups.CONCLUSION: ES is a safe and feasible tool as same as US used in laparoscopic TME with anal sphincter preservation for rectal cancer on the basis of the skillful laparoscopic technique and the complete understanding of laparoscopic pelvic anatomy. Application of ES can not only reduce the operation costs but also benefit the popularization of laparoscopic operation for rectal cancer patients.
机译:目的:探讨单极电灼铲(ES)在保留肛门括约肌的腹腔镜全直肠系膜切除术(TME)中用于直肠癌的可行性和安全性,以降低腹腔镜手术的费用,并将ES与超声激活手术刀进行比较方法:将2005年6月至2007年6月接受腹腔镜TME保留肛门括约肌的40例直肠癌患者随机分为超声手术刀组和单极ES组。记录手术前后白细胞(WBC),手术时间,失血量,盆腔引流量,肛门排气时间,视觉模拟量表(VAS)及手术相关并发症。结果:所有手术均成功。 ;没有人被转换为开放程序。术前和术后d 1和d 3 WBC计数(P = 0.493,P = 0.375,P = 0.559),手术时间(P = 0.235),失血(P = 0.296),肛门排气无明显差异ES组和US组术后第1天(P = 0.431,P = 0.426)和第3天(P = 0.844,P = 0.617)的时间(P = 0.431),骨盆引流量和VAS。两组吻合口漏和伤口感染等手术相关并发症的发生率相同。熟练的腹腔镜技术和对腹腔镜盆腔解剖学的全面了解。 ES的应用不仅可以降低手术费用,而且有利于直肠癌患者腹腔镜手术的普及。

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